Dr. James Sebesta is a surgeon who retired last year from service at Madigan Army Medical Center after an Army career that included four deployments to combat zones in Iraq and Afghanistan.Sunday, he encountered some of the worst carnage of his career during what he called a “prolonged date night” as he attended the Route 91 Harvest Festival in Las Vegas. After surviving the onslaught of bullets unleashed in the worst mass shooting in modern U.S. history, he sent his wife away with friends to a safe place while he stayed behind to help the wounded.Lacking medical supplies or any of his surgical gear, he was forced to improvise, turning fence parts into makeshift gurneys as he joined dozens of others in the massive effort to rescue those injured in the gunfire.“This was worse. War is war,” he said Wednesday evening in an interview in his Thurston County home. “This was 22,000 people just enjoying a concert. It was very frustrating not being able to help people. I know what they needed, but I just didn’t have anything.”That night a gunman, Stephen Paddock, fatally shot 58 people at the festival from the Mandalay Bay Resort and Casino, and then shot himself.It became a mission to get people moved to where they could get help, handing the injured off to others, who drove them to hospitals in pickups because ambulances hadn’t arrived, Sebesta said earlier Wednesday during a news conference at the Tacoma facility where he works.